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on the republican line. caller: thank you for taking my call. the so-called reduction in medicare -- is this information or misinformation? are they really going to reduce the amount of money in medicare to pay for this plan? also, the public option. how come they do not want to fight for that? it seems to me that it would be a good way to go. if people are insuring -- purchasing insurance, they are responsible for reading the policy and numbing their coverage. it is just like taking out a loan. if you sign on the dotted line, you are responsible because it is a contract. i think republicans are just fear-mongering, trying to kill the bill simply because of the input of lobbyists. host: thank you for the call. guest: public comment on the medicare question. the pieces in the legislation that would reduce cost under medicare are comprised of a number of components that have been discussed by legislative advisory commissions in the past, such as the medicare advisory council, which advises congress on issues of payment in medicare. issues have also been raised by the congressional b
't know the exact number but clearly with the body of medicare of 55 and over we are going to pick up two or 3 million more. now you've got the program operated by the opm and you have a bye in there of several million people. there's a provision most people haven't focused on which is a state can set up a separate program for people, government-run between 133% of poverty and 300% of poverty and any number of states will essentially do that. finally in all probability the exchanges are going to be run by the states. so, as that system comes forward you've got a bigger medicare, bigger medicaid, the fixed rates other components which are going to have negotiated rates. the bad news is going to take four years, five years to get this up and operating so i'm not sure there's going to be a lot of changes. but i think we have to start thinking how do we bring those together? it may be that medicare and medicaid are dictating rates for the groups that are negotiated. >> if we take that as a presumption we are going to see something built i would like you to respond what we were talking about h
for this? cutting half a trillion dollars out of medicare and you are going to be taxing people at a time they cannot afford it. we can do better. we can go back to the drawing board. it will not take 15 years. not on my watch. i will make it a priority to have coverage that states can rely on and have the flexibility. not a one-size-fits-all for the country and the hurting states. >> i am going to turn to you and you can -- all of you have talked about the economy. voters put jobs at the top of their list. everyone is worried about 10% unemployment. it is also true that this terrible economic situation workers find themselves in comes at the end of a lost decade for american workers. there has been nationwide, no net job growth since december, 1999 and middle class families when adjusted for inflation have not seen their incomes rise. what are your plans not only short term but what is the answer to the long-term challenge for jobs for americans? >> if i can no to that the congressional budget office says within 10 years that health care plan will be deficit neutral. one of the reasons w
on the report from members of the center of medicare and medicaid services. this is a 55 minute event. >> good morning, i'm the editor in chief of health affairs. having a year. welcome to our briefing on the health spending numbers. this is a ritual at the center for medicare and medicaid services as willis health affairs to bring out the spending numbers every year. we are delighted to be able to do that once more. this year we have a historic set of numbers to help others unveil. you will hear and perhaps you have already read the historic slow down in health-care spending in 2008. the slowest rate of growth in 50 years. on the other side of the story some health-care spending grew faster than the overall economy. we are not out of our long-term trajectory. we continue to outpace the growth in the gdp. with no further ado, i will turn into our fine folks who will explain the data further. this person is very knowledgeable. we will hear from another person who is an economist at the centers for medicare and medicaid services. she was primarily on historical state based spending. she and her
't talking about medicare advantage when they referred that. the bills in the house and senate include massive cuts in the medicare advantage program. and so people that have med can care advantage have vin vative new private insurance available for million office seniors and me digap policy. but also recognizing that the business of creating the massive new government run health insurance exchanges. and then allowing businesses to not offer health insurance if they just pay an 8 percent tax to the federal government will create an incentive where you'll see by some estimate maybe 100,000,000 americans could lose insurance through they're employers. not because the government would make them drop they're insurance you understand? you know, i think i remember the president saying one time, nothing in this bill requires you to give up your insurance. - or you know give up insurance you have through your employer but respectfully as i've said, it's hard to keep the healthcare insurance you have at the place of employment if your employer cancels it. and in this tough economy and i don't h
that passed, there was a massive savings expected in medicare i believe estimated 5 billion over the first few years and $1 trillion over the first 10 years of full implementation and 3 trillion over 20 years of implementation. that was transferred from the medicare savings are used to expand the other activity of the government's, specifically the expansion of medicaid and the new entitlement that was in the bill. if those dollars were used which were saved for medicare to shore up medicare and in some manner manner, in a medicare reserve fund to pay down debt, could you give us a thumbnail estimate how much that might help correct the structural problems that we have? >> i cannot do quantitative acquisition in my head by you're watching is correct that we estimated almost 500 billion in medicare savings over the 10 year projection point*. and over time if they not separately quantify. >> let me combine a question come if you did not use it to expand the government but instead to shore up the medicare system by reducing fed debt wouldn't that have a significant positive the event for medicare
to lower the costs of medicare and medicaid and it will not cost anybody anything. that is great politics, it is just not true. so there has got to be some test of realism in any of thesexd proposals, mine included. i have to hold myself accountable and guarantee the american people will hold me accountable if what i am selling does not actually deliver. >> mr. president, a point of clarification. what is in the better solutions book are all the legislative proposals that were offered. >> i understand that. i have actually read your bills. >> through 2009. >> i a understand. -- i understand. >> the summary document you receive this backed up by precisely the kind of detailed legislation that speaker pelosi android restoration have been busy ignoring for 12 months. >> i have read your legislation. i take a look at this stuff and the good ideas we take. here is the thing that all this have to be mindful of. it cannot be all nothing, one way or the other. would the mean by that is thisÑi if we put together a stimulus package in which a third of it are tax cuts that normally you'd support an
to go to a certain facility, this case first before medicare pays. it is fair. they are still providing a roof over your head and other things. quality is another issue. the second piece is if you use a home community-based option with medicaid and the package of options in the state include the tough stuff such as desisted technology, transportation, personal assistance. -- assisted technology, transportation, personal assistance. you still need $1,500 to do other things in your house. whatever your acute bonus injury is, this is on top of it. that is how we try to leave this. the last beasley tried to do is swear senator kennedy had been all wrong. this was never meant to put certain people out of business. we did a lot of exploration as to where this has been our of the last few years and where they are right now. they need a jump-start in order to work. this program is not the end all be all. it is to go together with the long-term care products that are out there. we had the five years in here for a reason. it was to make sure that the government that the participation they needed.
. there it is good news. compared to medicare, social security is in reasonably good shape. with some relatively small adjustments, you can have that solvent for a long time. i know people are concerned about it. social security we can fix. in terms of the cola, it stands for the cost of living allowance. it is put in place to make sure that social security is keeping up with inflation. here's the problem. this past year, because of the severity of the recession, we did not have inflation. we actually had deflation. so prices actually fell last year. as a consequence, technically, seniors were not eligible for a cost-of-living adjustment because prices did not go up in the aggregate. that does not mean that individual folks were not being pinched by higher heating prices or what have you. but on average, prices went down. here's what we did. of congress here, we did vote to provide a $250 one-time payment to seniors, which, when you factored it in, amounted to about 1. 8 percent. so it was almost the equivalent of the cola, even though it wasn't actually the cola. so we didn't forget seniors. we
dollars cut from medicare, you're going to look at blogger lines and less coverage. we know we need to reform pricing and it's something we are doing shortly but today we will have a one-size-fits-all plan in congress is going to come down here in massachusetts and heard what we have, that is one of the difference between martha coakley and ipt were talking to a trillion dollar health care plan, half a trillion dollars in medicare cuts at a time we just needed. i would propose actually going and allowing the states to do it individually with the government incentivizing it. similar to what we did here. we could export out what we've done and show them how to do it, so i'm looking forward to having the opportunity to be the 41st vote and make sure that we get that back to the drawing board. >> this coakley. >> thank you comedy for hosting us these evening. i would be proud to be the 60 votes to make sure we get health care reform we badly need. we've taken the lead in massachusetts and getting it to be in short and now we are attacking costs to make sure we provide for transparency a
. 60% of all health care is run by the government today. medicare, medicaid, indian health service, military, and v.a., tricare. 60% of it is run by the government. one of the reasons you have an absolute shortage of primary care doctors in this country is because we have set the price for what they're going to pay for primary care and the doctors won't go into it anymore, because there's a 350% payment differential. so we can either embrace our heritage, which says we've relied on markets to allocate scarce resources, or we can deny it and allow the government to run it. i think the health care bill ultimately will pass. i think they're going to buy the votes. you saw what happened in the senate. they're going to dot exact same thing in -- do the exact same thing in the house to get the votes they need and we will have a health care bill that the president will sign. don't think it's the best answer for us as a nation. i can tell you what's in that bill. it puts the government in charge of what you'll get, when you'll get it and where you'll get it, and that's even if you have pri
down premiums, bring down the deficit, cover the uninsured, strengthen medicare for seniors and stop insurance company abuses, let me know. let me know. i'm eager to see it. here's what i ask congress, though. don't walk away from reform. not now. not when we are so close. let us find a way to come together and finish the job for the american people. let's get it done. let's get it done. now, even if health care reform would reduce our deficit, it's not enough to dig us out of a massive fiscal hole in which we find ourselves. it's a challenge that makes all others that much harder to solve and one that's been subject to a lot of political posturing. so let me start the discussion of government spending by setting the record straight. at the beginning of the last decade the year 2000 america had a budget surplus of over $200 billion. by the time i took office, we had a one-year deficit of over $1 trillion and projected deficits of $8 trillion over the next decade. most of this was the result of not paying for two wars, two tax cuts, and a
for the part d medicare, which they snuck through in the middle of the night. i watched it all night. i'm a democrat. but i listen to fox, i listen to glenn beck, kennedy, o'reilly, chris matthews, keith okayer ton. i listen to it all. i didn't have the best of circumstances when i came up. i didn't graduate high school. but i went back and got my high school diploma and got a job. they sent me to school. >> right. >> caller: and the constitution says that i hear you keep talking about the constitution the constitution says this the constitution says that. the constitution never said that huh to have farming to take care of anybody houses, the constitution never said that you had insurance on cause if you want to have a cause. >> host: hey, james. we're just a little tight on time. what would you address michael steele to address? >> caller: why did they lose the race in maryland if he was such a great listener? >> well, you know, governor ehrlich and i did the unthinkable. we won after 40 years of having democrats in maryland, the last republican governor before ehrlich was sparagnon.
middle-age because the pattern of the war. most are going to qualify for medicare any way. the va has excess capacity. soon it's going to have a lot more excess capacity. it is less the world war ii generation and the korean war passalong. it's also been a winning for a decade now has literally offering the best care anywhere on metrics ranging from patient satisfaction to the use of information technology, evidence based medicine. anybody remotely acquainted with the quality of literature on health care the last decade would know the va has the best care anywhere. also, although it is hard to get a card number it appears the cost per patient as compared to medicare is about two-thirds. so this is a triple winner. open up the va to the vets who can use the medicare entitlement not only that, open it up to their wives, let them buy into the system. this now makes clinical sense but 8-year-old veteran scott more bdy with their wife, they have to take care of their tether to the coverage of the buttocks sense because every person of medicare and to the va you have saved about one third a
of the provisions the closing of the doughnut hole, that's how much the people on medicare have to pay out of pocket for their medication. we want to close that gap so people don't have to pay that much. we do it in the house of representatives, and so that was i think a lot of the conversation. so it isn't super yet. >> host: recovered a town hall meeting with stupak in michigan he talked about his amendment on abortion. it's part of the house legislation. did that come up last night and what is the fate of that do you think? >> guest: eight date. the pro-choice caucus which i'm part of, which has well over 100 members in the house of representatives and wide support throughout the country reproductive health care being part of any package. it came up last night in the context of those of us who are pro-choice believe that we ought to stick with the status quo that says and i want to say very clearly not any federal dollar to pay for abortion. we don't necessarily like that but we agree with that. that is the hyde amendment. and the stupak amendment and the nelson amendment and the samet go well be
security, medicare, minimum wage, at 40 hour week and civil-rights act and voting rights act. that is what made the united states a beacon of hope in a confused and divided world. too many people take for granted government's role as protector of wall street and the privilege. they see middle-class americans as overpaid, and underworked. they see social security as a problem rather than the only piece of our retirement system that actually works. day -- they fail to see the connections and in a quality and homelessness. the world view has brought democrats nothing but disaster. they offered middle-class the false hope of tax cuts. tax cuts and up enriching the rich, devastating the middle class by destroying the institutions like public education and the social security that makes the middle class possible. are you trying to tell me something? [laughter] >> we are now with our ku and a point*. >> i am not done with what i have to say. [applause] >> it has been 25 minutes and we will start. >> did you wrap up in 30 seconds? >> i can wrap up in a couple minutes working people have been waiti
is important. it is a question of whether we're going to raise taxes and cut $500 billion from medicare. i think that we can do it better. to be the 41st center and bring it back to the drawing board, there were very good things that you just pointed out in the national plan that is being proposed, but if you look at in a parochial matter, we need to look out for massachusetts first because no one -- i have felt that as a legislature and a citizen that we have not done that very well. we've always thought about maybe washington first or the party first. but the thing i am hearing all throughout the state is, what about us? thank you. nice to see. >> you ran as an independent. you are elected as an independent. what is first in your agenda, your number one priority to show that you are the independent that it wanted to send to washington? >> i have not had much sleep yet. but that being said, i will meet with a delegation tomorrow, all of which are democrats, and i will check in with the republican leadership, and obviously senator mccain he was helpful from the beginning. people need to se
for example to put in place medicare and medicaid but i think it is more like to my mind covering the seniors. seniors are no longer the poorest americans. young people are now, kids. there was a day in american life seniors especially older women really were in need of protection, social safety net we saw some of that with social security and don't forget covers widows or if it's that kind of thing and then of course with medicare again to pick up the idea we should not be struggling for health care coverage and now i think the extension would be to make sure all americans have some basic level of health care coverage and people don't have to scrap for, don't have to worry about having some kids to kill mr. will bankrupt them and it's not only then. we think it in terms of individuals, but i can't tell you how often when i am not doing reporting i come across people who are small business owners who complain to me about the high cost of health care benefits for employees, and of course we see what happened with auto companies. so it becomes larger, snowballs quickly by come back to the indiv
for medicare advantage or the $11 billion in clinics in maine or the louisiana purchase or it might be exemptions from executive pay controls in big phrma, it could be anything. it will add and add and add over on this side until all of this no political capital, all who knew it was a bad idea what it began, enough has moved to the plus side, to neutral, where if you put that final little weight on the skile, i like to call it the straw that breaks the camel's back, clink, it goes over this way. now there's enough support to pass a bill and that's when they ram it through and they don't let you up for air because they're afraid they'll lose votes . when that little moment comes, when they think they've got the votes, it comes through and that's why, that's why the united states senate was doing business for three constant weeks without a break and that's why they were doing business on christmas eve, to pass socialized medicine, with the 60-40 majority on december 24, christmas eevek, because they finally stacked the scales to the point where, clink, it would go over on the side whe
. it will raise taxes. it will hurt medicare. it will destroy jobs and reincarnations -- and ruin our nation -- and run ourn ation deeper into debt. it is not in the interest of our state. it is not in the interests of our state and country. we can do better. >> [chanting "yes we can"] when i have travelled, i've had a lot of fun. you guys are all having fun. thank you. we have more of a show coming for you. we are very excited. when i am in washington, i will work in the senate with the democrats and republicans to reform health care in an open and honest way. no more closed door meetings and backroom deals. -- with an out of touch party leadership. no more hiding costs. no more leading trillions in debt for our children to pay. in health care, we need to start fresh. we need to start fresh and work together to do the job right. once again, we can do better. i will work in the senate to put government back on the side of people who create jobs in the millions of people who need jobs. remember, as president john f. kennedy stated, that starts with across the board tax cuts for businesses and
care for over 20 years and watched the company's dream that the medicare system. i watched the prescription drug companies work with the doctors or prescriptions to benefit them in the pharmaceuticals, so this -- republican mr. brown is going to give to the senate -- i just heard the lady that said olympia snowe is going to have a hard battle. this leedy is a republican. but she's moderate. they don't know whether they want a conservative republican or the old a moderate republican. and it don't make any sense the way that this country is just fighting over something unless you have health care one-to-one. 80% of the people don't even know what it is. they don't see what is being billed. if they have insurance. >> host: jennifer call. the house and senate back in session this week. a week from tomorrow the president will be delivering his state of the union address. of course, live coverage here on c-span and the media network classes been retial, here in washington and nationwide on xm channel 32. gina is joining from north adams massachusetts. did you vote in today's spec
war. this is not going on for a point* security going bankrupt and had to be saved. medicare went bankrupt in the late 90's and general revenue was added. we are in it because of the recession but it is more intense than ever. my feeling is we go through a variety of options the for don't get day strategy for the future along the lines of -- if we don't get a commission that has teeth and we will default and that will be a long tough fight. >> just one thing before we move on. i appreciate your historical perspective and appreciate when they wrote ran against each other that was worse than partisan stance provide take a shorter view of history which is what i know. it to me it looks like a straight downhill slide in the ability of people of good will from both parties to get together and address the problems of common public interest as opposed to constantly looking for an edge in the next election. do disagree? >> i do. that is why i am here. [laughter] the key factor is the south have two-thirds of their leadership positions and you have long term democratic control. larry is th
me a dime. i could be on medicare but i chose not to do it. i have been with the va since i got out of the service in 71. but why are all these-- and inuit costs >> host: thank you dean. in fact testing and how much doctors employed them has been in regular theme of yours. here's what they yorker article with the headline testing testing. how will the guide to the point where doctors are calling on lots of test that even sometimes they say are gold-plated then? >> guest: your caller did hit the button on one of the issues driving prices which is our malpractice system, which is driven in ways that-- let me give you an example. headaches, one community actually tried to look at how many ct scans and cedar rapids iowa they were doing for people. they found they did 50,000 ct scans for a population of 300,000 in a year. all of us know that this is a necessary and 10,000 of them were for a head ct scans. only a tiny number ended up turning up any abnormality. many were just ordinary headaches. some of them for fear of malpractice suits and a more significant part of it is that we have n
in november? also, are you willing -- the government cannot take its hands off my medicare? >> we may get at some point of crisis in which we cannot any longer avoid facing this issue. t(we are hoping to point out tht that crisis is sufficiently imminent said that we have to move ahead. we think that is likely to be persuasive. it is not that the leadership of the congress and the administration did not know about this problem. it is not that they do not know what some of the options are. but so far, partisanship has prevailed and we hope we can turn that around. >> i think it is obvious to the leadership in both houses know the problem is a big one. they know it is a bad one. if we can just add to the trepidation, to the fear that this is something really big and that we'd better think big and at bigç -- and act big, so politically we are doing something we would not otherwise do. if we cannot do that, we are not addressing the problem. one more. >> "the new york times". i want to know, especially from the senator, one of the biggest things is problems facing the congressional white ho
for medicare and medicaid services. wow, that is a lot. please join me in welcoming debbie powell. [applause] >> thank you very much lori for that warm introduction. i really that old. i have had just short stents everywhere. i want to thank the national network for you for inviting me to participate in this symposium this year. it gives me an opportunity to its thank you for all the work that you do and the pleasure of meeting many of you, because at thisbe we know that you were the people that keep the trains running without all of the excellent services you provide, our program would be merely legislation. so i asked and i accepted the opportunity to come in introduce myself today because there has been a change in leadership and i want you to see my face and to thank publicly the director now of the runaway homan youth program, curtis porter for the wonderful leader mackey has provided at fisbe for several years. curtis, stand up. [applause] i have to say that because i have bennett fisbe for a year and i was hired there is the deputy associate commissioner and curtis was the acting asso
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